WHAT IS PANIC DISORDER?

Panic disorder is a type of anxiety condition where a person has repeated, unexpected panic attacks. A panic attack is a sudden surge of intense fear that can come with strong physical sensations, such as a racing heart, sweating, shortness of breath, or dizziness. These attacks can feel frightening and overwhelming, and people often worry they are dying or losing control, even though there is no real danger.

Because panic attacks can be so upsetting, many people start to worry a lot about having another one. This fear can lead to avoiding certain places or situations where an attack happened before, which can interfere with daily life. The good news is that panic disorder is very treatable. Therapy, and sometimes medication, can help people feel more in control and get back to living their lives.

Pink pegboard wall with white block letters spelling 'DON'T PANIC'.

What happens during a panic attack?

You experience physical and emotional/mental symptoms that include:

  • Pounding or racing heart

  • Trembling or shaking

  • Chills or hot flashes

  • Nausea or stomach discomfort

  • Chest pain or tightness

  • Shortness of breath

  • Dizziness or lightheadedness

  • Numbness or tingling

  • Intense fear or terror

  • A sense that something terrible is about to happen

  • Fear of losing control or “going crazy”

  • Feeling unreal or detached from your surroundings (derealization)

What makes panic disorder different from general anxiety?

  1. Unexpected attacks: Panic attacks often come out of the blue, without a clear trigger.

  2. Fear of another attack: Ongoing worry about having future attacks, which can lead to avoidance (such as avoiding driving or public places).

  3. Impact on daily life: The fear and avoidance can interfere with work, relationships, and everyday activities.

How long do panic attacks typically lasts?

Panic attacks usually peak within a few minutes, but the sensations can linger longer.

TREATMENT FOR PANIC DISORDER

COGNITIVE BEHAVIORAL THERAPY:

CBT is one of the most effective treatments for panic disorder. It helps you understand how your thoughts, feelings, and behaviors are connected and teaches you practical skills to reduce fear and avoidance. You learn how anxiety and panic work in the body and why symptoms feel so intense but are not dangerous. This helps reduce fear of the sensations themselves.  CBT helps you notice fearful thoughts like “I’ll lose control” or “I am going to die.” You learn to challenge these thoughts and replace them with more realistic, balanced ones.

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EXPOSURE THERAPY:

Exposure therapy is a highly effective treatment for panic disorder. It helps you learn that panic symptoms, while uncomfortable, are not dangerous and do not need to be feared or avoided. Repeated exposure retrains the brain. Instead of reacting with fear, your nervous system learns that panic sensations are false alarms. Over time, panic attacks become less frequent, less intense, and less scary.

Through repeated practice, your nervous system becomes less reactive. Instead of responding with intense fear, it learns that panic symptoms will pass on their own. Over time, panic attacks often become less frequent, less intense, and much less frightening.

Rather than avoiding panic symptoms or situations that trigger fear, exposure therapy helps you face them gradually and safely, with support. As you practice, anxiety naturally decreases, confidence increases, and fear loses its power. This allows you to return to living your life without panic controlling your choices.

Types of exposure used in panic disorder:

1. Interoceptive exposure (body sensation exposure)
This involves intentionally bringing on physical sensations that feel similar to panic, such as: a racing heart; shortness of breath; dizziness or lightheadedness. You might do exercises like spinning in a chair, running in place, or breathing through a straw. The goal is to learn that these sensations are uncomfortable but not harmful, and that they pass on their own without needing to escape or “fix” them.

2. Situational exposure (real-life exposure)
If you avoid certain places or activities because you fear having a panic attack there (such as driving, stores, crowds, or being alone), exposure therapy helps you gradually return to those situations. You practice staying in them long enough for anxiety to rise and fall naturally.

Medication

Medication can be an effective part of treatment for panic disorder, especially when panic attacks are frequent or severely disruptive. Medications help calm the nervous system, reduce the intensity of panic symptoms, and lower the fear of future attacks. They are often used together with therapy, such as CBT or exposure therapy, for the best results.

1. SSRIs (Selective Serotonin Reuptake Inhibitors)
These are usually the first choice for treating panic disorder.  They help regulate brain chemicals involved in anxiety.  The benefits build gradually over several weeks.

2. SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
Another common option if SSRIs are not effective or tolerated. These work over time to reduce panic and anxiety.

3. Benzodiazepines (short-term or limited use)
These medications can quickly reduce panic symptoms. These work rapidly, are used short-term or occasionally. They are not usually a first-line, long-term solution due to risk of dependence.